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Interpretation of serologic tests

Interpretation of serologic tests

What does a "nonreactive" test result for Hepatitis B surface antibody indicate?  Is nonreactive the same as negative?
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The test for an active hepatitis B infection is the hepatitis B surface antigen. If some one has a negative hepatitis B surface antigen, they are almost certainly not infected. A positive hepatitis B core antibody means that some one was exposed to the virus at some point in their lives.

You cannot get a positive hepatitis B core antibody from the vaccine because the vaccine does not include the core protein. However, over 95% of people exposed to hepatitis B as adults get rid of the virus by themselves. They are then permanently immune from being infected by the hepatitis B virus again. If somebody is hepatitis B core antibody positive and hepatitis B surface antigen negative, they are likely to be one of those individuals.
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for simple serologic tests "nonreactive" has the same meaning as "negative". However, for some complex tests, like HIV, reactive/non-reactive refers to a component of the overall test (ELISA or Western Blot) and positive/negative refers to the final interpretation.  

Interpretation of Hepatitis B results is a bit complex as Galen points out  and depends on three separate tests (see <a href="http://www.vaccinationnews.com/DailyNews/March2002/HowInterpretHepBPanelResults.htm">table</a>).
Basically, non-reactive for the antibody to the hbv surface antigen tells you you've never developed immunity but doesn't tell you why (never exposed, acutely infected, chronically infected, etc. - see the possibilities in the table under "antiHBs negative").
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